Army I am a 35 y/o subspecialist who just completed the Basic Airborne Course ("jump school"). Questions?

[turkish]

Involuntarily, I might add.

Fire away.

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[Slevin]

How will this improve your practice of Medicine?

 

[turkish]

It will improve my understanding of airborne operations and the unique medical planning that should take place around them, and will make me "one of the guys" around my unit, where I'm the brigade surgeon. But it will not make me a better X-ologist now or in the future, and the time away from practice degrades the quality of care I provide for the patients I see within my subspecialty...if I ever get to practice it again.

 

[244913]

It will improve my understanding of airborne operations and the unique medical planning that should take place around them, and will make me "one of the guys" around my unit, where I'm the brigade surgeon. But it will not make me a better X-ologist now or in the future, and the time away from practice degrades the quality of care I provide for the patients I see within my subspecialty...if I ever get to practice it again.

173rd Airborne huh? Enjoy Vicenza. What exactly did you expect when you got assigned to an Airborne unit?

When I did my gmo time you actually checked a box saying "I volunteer for Airborne training."

Nobody forces you to go to jump school. Peer pressure from the Staff and your Colonel probably leaned on you but "involuntarily" is a bit of a stretch.

It's a pretty unique and cool thing and it's another story to tell. Congrats and strong work.

- ex 61N

 

[colbgw02]

One the prouder moments of my military career, as meek as they might be, was becoming third generation airborne qualified. So definitely congrats to you. Of course, it was probably a lot easier as a 20 year old, so kudos to you for doing it at our age. Then again, back then they made you pass a ridiculously difficultly graded APFT and the Ft. Benning summer heat is no joke. Get off my lawn!

 

[Chonal Atresia]

It will improve my understanding of airborne operations and the unique medical planning that should take place around them, and will make me "one of the guys" around my unit, where I'm the brigade surgeon. But it will not make me a better X-ologist now or in the future, and the time away from practice degrades the quality of care I provide for the patients I see within my subspecialty...if I ever get to practice it again.

I feel for you with regard to skill atrophy and practicing your specialty. I was there 3 years ago and barely escaped the "brigade surgeon initiative."

I wish you luck and maybe you will be allowed to operate a small amount. Hopefully you will have time to "regain" you skills before leaving the military and trying to get credentialed at a real (non-military) hospital. I wish prospective med students would hear stories like yours. If this is what you wanted congrats, but I suspect it is not.

Military medicine has turned into a place that should only be filled by PCPs and surgeons (general and ortho) that want to deploy on a repetitive basis. Everyone else should be allowed to leave. Leadership has made it abundantly clear that they care about nothing else. The days of being a clinician and/or academician are over. What a cesspool!

 

[turkish]

173rd Airborne huh? Enjoy Vicenza. What exactly did you expect when you got assigned to an Airborne unit?

When I did my gmo time you actually checked a box saying "I volunteer for Airborne training."

Nobody forces you to go to jump school. Peer pressure from the Staff and your Colonel probably leaned on you but "involuntarily" is a bit of a stretch.

It's a pretty unique and cool thing and it's another story to tell. Congrats and strong work.

- ex 61N

The message was clear- if I wanted to take leave to travel back to see my children on a regular basis, and desired a decent OER, I would have to attend jump school. But feel free to split hairs.

 

[deuist]

I actually wouldn't mind jump school compared to all of the other training I had to go through prior to my last deployment. I have yet to find anyone in the Air Force who can tell me how to go to jump school, including people who have already been through it.

 

[Tipsy McStagger]

ahh yes airborne school. The 3 week school that could be done in 4 days.

The message was clear- if I wanted to take leave to travel back to see my children on a regular basis, and desired a decent OER, I would have to attend jump school. But feel free to split hairs.

yeah, the proverbial '90's officers / SGMs' are fixed-mindset, Machiavellian jokers.

 

[peanutsss]

.....

 

[sonofva]

Any thoughts on how PCPs and surgeons generally feel about their deployment experience? Satisfying, annoying, indifferent, etc?

I just got back from a course that was primarily deploying surgeons. They all seemed to have rewarding past deployment experiences saving peoples lives. I think GMO deployment satisfaction is dependent primarily on your attitude...

 

[pgg]

Any thoughts on how PCPs and surgeons generally feel about their deployment experience? Satisfying, annoying, indifferent, etc?

I'm an anesthesiologist but my last deployment was awesome. Modern, state of the art trauma hospital in Afghanistan, very busy. One of the most personally and professionally rewarding things I've ever done.

Of course, there was another anesthesiologist deployed at the same time who basically rotted at a Role 2 for seven months, and did a bare handful of cases. And I knew an anesthesiologist who went to Djibouti for 7 months and did one EGD for a soldier who got a piece of steak stuck in his esophagus. Their deployments were less rewarding than mine.

There were surgeons at all 3 of these places and their professional enjoyment or non-enjoyment of the experience probably mirrored the anesthesiologists' ... so much of a military career comes down to luck to be in the right place at the right time. To an extent, you can make some of your own luck.

 

[BigNavyPedsGuy]

I think GMO deployment satisfaction is dependent primarily on your attitude...

Spoken like a medical student. I had a good attitude, but was surrounded by a terrible leader and terrible senior enlisted leadership. It sucked. It would've sucked for anybody. Don't act like it's all about attitude.

 

[DeadCactus]

Sorry it was a bad experience for you. I'm still jealous that you got to go and many other physicians, officers, and enlisted are as well...

 

[sonofva]

Spoken like a medical student. I had a good attitude, but was surrounded by a terrible leader and terrible senior enlisted leadership. It sucked. It would've sucked for anybody. Don't act like it's all about attitude.

Not a med student. But a TY Intern, which I fondly call my pgy5 year. I'm hoping it's all about attitude. I'm sure I'll check in 5 months from now in BFE pissed as hell

 

[colbgw02]

Not a med student. But a TY Intern, which I fondly call my pgy5 year. I'm hoping it's all about attitude. I'm sure I'll check in 5 months from now in BFE pissed as hell

that must be one hell of a TY program. we just used to call each other MS5s.

 

[sonofva]

that must be one hell of a TY program. we just used to call each other MS5s.

Touché. Caught in my own sarcasm.

 

[IlDestriero]

To some degree it is about your attitude. I had to go to a very undesirable place where I would never choose to live or even visit. I suffered skill atrophy, I suffered boredom, I suffered some very questionable leadership and plenty of dumb ideas, BUT I did very well. I developed political skills, I developed leadership skills, I developed a few professional skills, and I put on some armor and hardened my spine taking some of the dumbest stuff to the mat as the dept head and drawing a firm line.
I then leveraged the above experience and spun it all to my advantage to secure an extremely competitive civilian fellowship and then an extremely competitive attending position.
I also worked on my golf game.
Choose to make the lemonade.

 

[peanutsss]

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[BigNavyPedsGuy]

@pgg @sonofva Thank you both for the feedback.


I'm sure you've explained this somewhere else, but did you end up in GMO straight out of school? Was it your first choice, or just something that happened? My understanding is that GMO is more prevalent in Navy. My AF recruiter maintains that AF GMO (flight surgeon) tour only happens if you fail to match two years in a row. From my independent research this seems to be a half truth, and largely depends on speciality desired and "in field" applicants.

I did a GMO after my Pediatric intern year. It was not voluntary and I did not want to do one at all. I had no choice in the matter, and I had performed well in my internship.

 

[sonofva]

A GMO happens in all branches after two years of failing to match. You must have at least done an internship to be a gmo

 

[244913]

Spoken like a medical student. I had a good attitude, but was surrounded by a terrible leader and terrible senior enlisted leadership. It sucked. It would've sucked for anybody. Don't act like it's all about attitude.

BNPG,

Why are you so relentlessly negative on these threads? You sound like I did 6 months into my second tour in Afghanistan. With time my feelings of disgust dulled to a distant ache. You're out, you've made it to greener pastures and you have a good story to share which includes shipboard GMO experience but when you post replies like that no one will listen to what you have to say.

You could be a valuable mentor to the Navy PGY 1's on this forum who are going to be walking down the same path you did if you'd just set aside some of your obvious hostility to the system.

- ex 61N

 

[sonofva]

I did a GMO after my Pediatric intern year. It was not voluntary and I did not want to do one at all. I had no choice in the matter, and I had performed well in my internship.

#YUMADBRO

 

[BigNavyPedsGuy]

BNPG,

Why are you so relentlessly negative on these threads? You sound like I did 6 months into my second tour in Afghanistan. With time my feelings of disgust dulled to a distant ache. You're out, you've made it to greener pastures and you have a good story to share which includes shipboard GMO experience but when you post replies like that no one will listen to what you have to say.

You could be a valuable mentor to the Navy PGY 1's on this forum who are going to be walking down the same path you did if you'd just set aside some of your obvious hostility to the system.

- ex 61N

1) his status says he's a medical student, not a PGY-1.
2) You're right. I'm in greener pastures. Now I can truly appreciate just how bad and how dangerous those situations the Navy forced me into were.
3) The majority of people asking questions on this site are pre-meds and I really feel a duty to warn them away from this terrible system.
4) I had a 3rd year med student (HPSP) from the nearest civilian med school rotating at my hospital who was interested in Peds. I took him to dinner. I put him in touch with multiple program directors and talked him through the match. I understand the value of finding a good mentor.
5) I guess somebody has to replace medicalcorpse as the voice of negative truth.
6) You probably have good points, but there's no way I'll admit that, cuz that's not what the internet is for

 

[BigNavyPedsGuy]

#YUMADBRO

yes

 

[peanutsss]

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[colbgw02]

In this situation, my understanding is that for EM and Ortho, Ms4 applicants would take a back seat to those with prior service. Where as anyone going IM or Gen Surg would go straight through. Am I missing anything here?

What you're missing is that programs won't necessarily take an applicant just because they have an open spot. You're also missing that not all applicants are vying for the the same positions. For example, a program may have 5 residents per year, and they've decided to take 4 medical students and 1 person from the "field". The application of these things changes depending on specialty, service, and year, so there's no overarching theme to be discerned.

 

[GMO2003]

Involuntarily, I might add.

Fire away.

F$&@ing insane...and the s$&@ keeps on a turning

 

[peanutsss]

"....

 

[sonofva]

On #1 above, what factors would result in a program not taking an applicant despite having an open?

On #2, what do you mean by not vying for the same spot? Do you mean physical location, active duty vs civilian? Also if they take 4 medical students and one from the field how is that different than the scenario I noted previously.

I know you said it can depend on specialty, service and year, so maybe you could provide an example that would help me understand better. I get the feeling you have an example in mind.

1 - the needs of the service. For example, there's a guy on this board who has been trying to get pmr for a long while now. And while technically there are residency slots available every year, his branch is swamped with pmr people already, so they don't authorize funding for any new pmr physicians.

2 - they're not vying for the same spots most often because programs already have a preset number of applicants from med stud pool and GMO pools they want to take every year. This number is fairly static from what I've seen. For example an ER program can have 5 overall spots. 4 will automatically go to med studs, one to GMO. The GMO peeps are competing against other GMO people for that one spot, not against the entire pool for 5 spots. The reason it looks like you're competing against GMOs is that they list the program has having 5 spots for incoming residents, which isn't true. They've got 4 plus one.

 

[colbgw02]

On #1 above, what factors would result in a program not taking an applicant despite having an open?

On #2, what do you mean by not vying for the same spot? Do you mean physical location, active duty vs civilian? Also if they take 4 medical students and one from the field how is that different than the scenario I noted previously.

I know you said it can depend on specialty, service and year, so maybe you could provide an example that would help me understand better. I get the feeling you have an example in mind.

Re: #1 - if an applicant is considered substandard, then a program might prefer to go unfilled that year rather than give a spot to that person. It's usually about board scores and/or grades. On occasion, someone's got a major red flag - usually stemming from a prior residency - that will basically black ball you from further military GME.

Re: #2 - it's as sonofva explained. Accordingly, t's not correct to say that MS4 applicants would necessarily take a "back seat" to anyone. Normally, these allotments are consistent within service and specialty, but not really from year to year. So, in year X, all Army programs from specialty A will accept 4 graduating medical students and 1 "field" applicant. But that won't apply to Navy programs from specialty A, nor is it a given that the Army would use the same foruma in year Y.

 

[IlDestriero]

1 - the needs of the service. For example, there's a guy on this board who has been trying to get pmr for a long while now. And while technically there are residency slots available every year, his branch is swamped with pmr people already, so they don't authorize funding for any new pmr physicians.

2 - they're not vying for the same spots most often because programs already have a preset number of applicants from med stud pool and GMO pools they want to take every year. This number is fairly static from what I've seen. For example an ER program can have 5 overall spots. 4 will automatically go to med studs, one to GMO. The GMO peeps are competing against other GMO people for that one spot, not against the entire pool for 5 spots. The reason it looks like you're competing against GMOs is that they list the program has having 5 spots for incoming residents, which isn't true. They've got 4 plus one.

That's not the way it works in the Navy. The interns and GMOs are competing against each other, which is why the GMO folks have a higher likelihood of matching and a new round of GMOs set sail each year.

 

[BigNavyPedsGuy]

That's not the way it works in the Navy. The interns and GMOs are competing against each other, which is why the GMO folks have a higher likelihood of matching and a new round of GMOs set sail each year.

There is also more year to year variation in the Navy depending on who is applying from the fleet (GMO, FS, UMO). I know in peds the match for the 2nd year varied a lot based on who was returning.

Which I guess points to one confusing point for the Navy system. You have 2 matches: intern year and the rest of residency. For things like Peds and OB with a Peds/OB specific internship that's fine, but for specialities like EM and anesthesia it's very tricky because you do whichever internship your first year and then compete with other GMOs for those spots.

I don't think the AF and Army have are like that, but I could be wrong.

 

[peanutsss]

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[deuist]

My AF recruiter maintains that AF GMO (flight surgeon) tour only happens if you fail to match two years in a row. From my independent research this seems to be a half truth, and largely depends on speciality desired and "in field" applicants.

Yes, that part is true. However, given that 25% of med students do not match, that's quite a few people who will head off to GMO/FS. Also, you already noted that certain specialties are much more competitive than others. As an example: while emergency medicine is only moderately competitive in the civilian world, it's significantly harder to get into in the military.

Do any if you know how the Air Force does it? (In terms of potential slotting MS4 vs GMO)

I'm unaware of pre-setting slots for returning flight surgeons. The current setup of the point system favors flight surgeons over medical students anyway.

 

[peanutsss]

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[BigNavyPedsGuy]

I was reading the HPSP Survival Guide published by ACOG. ( http://www.acog.org/-/media/Districts/AFD-Junior-Fellows/HPSPSurvivalGuide2013Update.pdf )

One thing I had a question about is the process of being selected for Active Duty, Civilian Sponsored or Civilian Deferred residency. The guide says if someone was banking on getting a civilian slot and neglected to prepare for the Active Duty residencies (away rotation performance, interviewing with Program Coordinator etc) they could potentially be selected for Active Duty consideration and not picked up due to lack of competitiveness. Conversely, if one was banking on going to an Active Duty residency but was instructed to proceed to the Civilian Match they could find themselves scrambling to get everything lined up to be competitive. Is the process of being selected for Active Duty, Civilian Sponsored or Civilian Deferred residency somewhat shrouded in secrecy or do people have a pretty good idea which category they are going to be slotted into as far as consideration?

You won't know for sure until the day you match (or don't match).

 

[deuist]

do people have a pretty good idea which category they are going to be slotted into as far as consideration?

No